Being a health care consumer

In today’s world, seeing a health provider is very different than it was a decade or two ago. For most people who need to seek non-emergency health care services, the world of health care is becoming more like a retail shopping experience. What’s changed?

Cost sharing changed the structure of benefits. The introduction of co-pays, increasing deductibles, increasing portions of benefits costs, and the reversed structure of high-deductible health plans have all required the consumer/patient to contribute more and more money out of pocket for care.

The content of benefits changed. The number of legislatively-required benefits, employer add-ons, consumer/employee preferences and other factors have changed what benefits and health plans actually cover.

Direct marketing. Drug companies pumped more than $8 billion into direct-to-consumer advertising in 2014, and as competition for patients has increased, hospitals, clinics, health systems and providers have followed suit. Everyone wants our business, and with this kind of competition price discounts, amenities and marketplace segmentation is taking place.

The changing value of provider networks. In-network and out-of-network provider cost differences have been significant, but as the emerging retail health care marketplace takes shape and as consumers pay more out of pocket, in practice health ‘insurance’ is often little more than a contractual discount. Other providers can meet or exceed that discount at their discretion, so networks mean less than they used to.

What does all this add up to? For the health care consumer, the ‘new world’ of retailized health care means that it’s more and more possible to approach health care services as you do a retail purchase. It’s more and more possible to identify competitors for your business and compare what they offer to see how to get the most value for your money.

A big part of getting the most for your money is figuring out what kinds of health care services meet your needs. For many, if not most non-emergency health problems (especially those related to lifestyle-based chronic health problems like diabetes, heart and circulation problems, digestive problems, etc.) holistic health care can offer some alternatives and answers that, when pieced together, create a more effective treatment and management plan. This approach is called various things: integrative care, alternative medicine, blended health care, holistic health care, and so on. What it means in practice is that different types of health providers often have evidence-informed contributions to your health.

Someone with headaches, for instance, may not tolerate the side effects of medicine, but finds that acupuncture helps. Or chiropractic adjustments. Or nutritional changes in their diet. Or….and on, and on. So how do we make sense of all this?